الفهرس 
Intramedullary fixation vs arthroplasty management of trochanteric fractures in elderly patients
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Abstract
Intertrochanteric fractures of the femur are very common in elderly people. Their incidence has increased due to the increased life expectancy and osteoporosis; fall is the main cause of injuries.¹ Most of the classification systems for intertrochanteric fractures have poor reliability and reproducibility. Intertrochanteric fractures are considered unstable in the presence of a comminuted posteromedial cortex, reverse obliquity, and subtrochanteric extension.² Early operation within 12 hours to 48 hours is mandatory in the relatively fit patients.The surgical goal is to achieve a painless and stable lower limb with early return of function, with the lowest rates of mortality and morbidity.³ As restoration of the preoperative ambulatory level correlated with survival rate after 1 year⁴ and elderly patients are often unable to cooperate with partial weight bearing, the primary stability of the device is crucial to allow early mobilization to prevent cardio-pulmonary complications and thrombosis.5 The mainstay of treatment of intertrochanteric hip fractures is internal fixation. Arthroplasty may be considered as a primary treatment in patients with highly unstable factures with poor bone quality, ipsilateral hip arthritis, or other conditions with a higher risk for early failure.⁵